Mesothelioma Cell Types: A Comprehensive Guide

Mesothelioma is a rare type of aggressive cancer, most commonly seen among people who have been exposed to asbestos. It is in the mesothelium, a thin lining of cells that covers many of our innermost organs and cavities, where this disease develops.

For accurate diagnosis and effective mesothelioma treatment, the disease is divided into different subtypes depending on what types of cells you have. When these cell types were understood, doctors could more accurately target treatments, and patients’ chances of survival were improved greatly as well.

Each three main mesothelioma cell types – epithelioid, sarcomatoid, and biphasic – have different characteristics and different responses to treatment, respectively.

Appropriate classification of tumor types utilizing endoscopic or histologic examination will assist oncologists in selecting the choice of treatment regimens.

Common Mesothelioma Cell Types

The three main mesothelioma cell types are epithelioid, sarcomatoid, and biphasic. Each has unique features, diagnostic methods, and treatment options.

Epithelioid mesothelioma is the most common form of this ailment, accounting for 60-70 percent. Its origin lies in the epithelial cells that make up the mesothelium. Characteristics include uniform, tube-like structures with other connective tissue and a relatively slow rate of growth.

This cell type is often associated with a better prognosis. Diagnosis involves imaging tests such as CT scans and MRIs, followed by a biopsy. Pathologists look for specific markers like calretinin and cytokeratin to confirm the diagnosis. Treatment options typically include surgery, chemotherapy, and radiation therapy, with epithelioid cells responding well to these treatments.

Sarcomatoid mesothelioma is rarer, accounting for 10-20 percent of all cases. It comes from the mesenchymal cells, which are connective tissue cells.

Characteristics include cells shaped like spindles that are looser in their assembly and thus more mobile. Because sarcomatoid cells in their general morphology resemble other types of sarcomas, diagnosis is complex.

Immunohistochemical staining is used to identify vimentin and WT-1. Treatment options are limited because sarcomatoid mesothelioma is so aggressive. Surgery is often impossible, and chemotherapy and radiation therapy have only a moderate effect. Clinical trials and experimental treatments are commonly considered for these patients.

Biphasic mesothelioma is made up of both epithelioid and sarcomatoid cells and makes up 20-30% of cases. The nature of the disease depends on how much of each cell type there is around. The prognosis and treatment options change with this.

Diagnosis involves finding bone marrow samplings demonstrating both cell types. The existence of both epithelioid and sarcomatoid cells can complicate both diagnosis and therapy. One works based on the prevailing cell kind. Treatments may be more aggressive, similar to those for epithelioid mesothelioma, should epithelioid cells be primarily involved.

However, if they center on sarcomatoid cells then treatment is generally less aggressive and proceeds towards palliative care.

Knowing the common mesothelioma cell types—epithelioid, sarcomatoid, and biphasic—is crucial for accurate diagnosis and effective treatment. Each type has distinct characteristics that affect treatment choice and outcome.

Rare Mesothelioma Cell Types

Desmoplastic mesothelioma is a distinctive form of sarcomatoid mesothelioma, with a tightly compacted fibrous structure. This type is often seen as hard, fibrous ridges containing collagen which can sometimes be mistaken for benign fibrous tissue during diagnosis.

Patients suffering from desmoplastic mesothelioma have a poor prognosis, with a median survival time of less than a year. Treatment options are limited and usually include chemotherapy as well as radiotherapy–although these would be more for palliative purposes than to cure the disease.

Lymphohistiocytoid mesothelioma is another rare variant, distinguished by the presence of lymphocyte-like and histiocyte-like cells. This type can be easily confused with lymphomas or other inflammatory conditions due to its cellular makeup.

The prognosis for lymphohistiocytoid mesothelioma is generally poor. Like other types of mesothelioma, the median survival time is about a year. Treatment usually involves multiple options, such as surgery, chemotherapy, and radiotherapy. The effectiveness is often limited, however

One particular rare variant is deciduoid mesothelioma, typically diagnosed in younger women. It is characterized by large, decidua-like cells. The prognosis for deciduoid mesothelioma is different; some research shows that it may have better prospects than other types of mesothelioma, but overall survival rates are low.

Because the subtype is so rare that standardized treatment protocols are not well-established, treatment may consist of surgery, radiation therapy, or chemotherapy.

Diagnosis and Detection of Cell Types

Diagnosis of mesothelioma is complicated. It consists of several steps: if you suspect that someone has mesothelioma, get a history of the case and put together background information/clinical data for diagnosis.

Imaging techniques such as CT scans, MRI, and PET scans help in identifying the extent and location of the disease. Histopathology involves the microscopic examination of stained tissue sections to identify the specific cell types present.

Diagnosing rare mesothelioma cell types poses significant challenges. These subtypes often mimic other diseases, making them difficult to identify. For instance, desmoplastic mesothelioma can be mistaken for benign fibrous tissue, while lymphohistiocytoid mesothelioma can resemble lymphomas.

The rarity of these cell types also means that pathologists may have limited experience in identifying them, further complicating diagnosis.

Immunohistochemistry (IHC) plays a vital role in accurately identifying mesothelioma cell types. IHC involves the use of antibodies to detect specific antigens in the cells, helping to differentiate mesothelioma from other conditions.

For example, markers such as calretinin, WT-1, and cytokeratin 5/6 are commonly used to confirm a mesothelioma diagnosis. IHC is particularly useful in distinguishing rare cell types, providing a more precise diagnosis, and guiding appropriate treatment strategies.

Patient Stories and Case Studies

A 58-year-old construction laborer named Stannis Warborn was once diagnosed with epithelioid mesothelioma — this being the most common form of cell type.

Following surgery and chemotherapy, the tumor diminished considerably; he began to lead a better life without pain from the cancer. In contrast, Mary, a 65-year-old teacher, was struck by sarcomatoid mesothelioma. This form of cancer is less common and more virulent than the other two.

Common Questions on Mesothelioma Cell Types

Below are some of the common questions we receive regarding the types of cells related to mesothelioma.